AU2010244592A1 - Recombinant human alpha1-antitrypsin - Google Patents

Abstract

The present invention relates recombinant human α1-antitrypsin (rhAAT) comprising N-linked glycans, wherein at least 10% of said N-linked glycans are tetra-antennary glycans; and the degree of capping with sialic acid on said N-linked glycans (Z/A) is at least 50%.The invention further relates to rhAAT for use as a medicament, in particular for use in the prevention and/or treatment of a disease associated with AAT deficiency, and/or a disease involving neutrophil-mediated tissue damage.

Description

WO 2010/127939 PCT/EP2010/055177 RECOMBINANT HUMAN ALPHAl-ANTITRYPSIN [0001] The invention relates to the field of pharmaceutical products, in particular to recombinant human al-antitrypsin, that can be used for inter alia the 5 prevention and/or treatment of a 1 -antitrypsin deficiency related emphysema. BACKGROUND OF THE INVENTION [0002] ai-Antitrypsin (AAT) or a-protease inhibitor (alPI) is a natural inhibitor 10 of proteases released by activated neutrophils. AAT is a glycoprotein consisting of 394 amino acids and having a molecular weight of 52 kD. Human AAT is expressed as a 418 amino acid precursor from which a 24 amino acid precursor is clipped to yield the 394 amino acid final product. AAT is synthesized primarily in the liver, but expression has also been demonstrated in neutrophils, monocytes and macrophages. 15 [0003] Low or zero plasma levels of AAT constitute a risk factor for the development of emphysema due to the unopposed and destructive action of neutrophil proteases in the lungs. For the prevention and/or treatment of AAT deficiency-related emphysema AAT augmentation therapy has been developed (Mulgrew et al., 2007). [0004] Currently, patients with AAT-deficiency-associated emphysema are 20 treated with a high dose of plasma-derived (pd)AAT (60mg/kg/week; Prolastin* from Talecris, Aralast* from Baxter and Zemaira" from ZLB). Large quantities and frequent injections of AAT are required to relieve AAT-deficiency related emphysema. Major concern with the plasma-derived material is the safety of the preparations. As with all human-derived material, potential risk of pdAAT is contamination with prions or other 25 adventitious agents. A second concern is the limited availability of the plasma material. [0005] Human plasma derived AAT contains three N-linked glycans at Asn residues 46, 83 and 247. These glycans consist of mostly di- and tri-antennary structures. A high degree of sialylation of the glycans on recombinant proteins is of importance for optimal pharmacokinetics (PK). 30 [0006] Until now recombinant production of AAT has been hampered by low expression in most recombinant platforms (Karnaukhova et al., 2006). Recombinant AAT WO 2010/127939 PCT/EP2010/055177 2 has been produced at high level in transgenic systems, but clinical development thereof has been stopped because of suboptimal pharmacokinetics (PK) and safety issues due to non-human contaminants (Spencer et al., 2005). [0007] There thus remains a need for recombinant human AAT (rhAAT) that is 5 active, can be obtained in sufficient quantities, and that has useful pharmacokinetic properties. BRIEF SUMMARY OF THE INVENTION 10 [0008] According to the present invention, it has been shown that recombinant human a-antitrypsin (rhAAT) having a suitable pharmacokinetic profile can be produced in large quantities in PER.C6 cells. [0009] In the research that led to the invention, cell lines expressing human AAT and co-expressing an a-2,3-sialyltransferase (ST3) or an a-2,6-sialyltransferase (ST6) 15 were generated under serum-free conditions. The cell lines were capable of expressing high levels of rhAAT. Thus, yields of up to 22 picogram rhAAT per cell per day (pcd) were reached. Importantly, the rhAAT of the invention was shown to be active as a neutrophil elastase inhibitor. Analysis of the glycan profiles showed a good overall degree of capping with sialic acid. Interestingly, an increase in tetra-antennary glycans 20 was noted on the rhAAT of the invention, as compared to plasma-derived AAT (Prolastin"). Furthermore, rhAAT produced in cells co-expressing ST3 showed an increased mean residence time (MRT) in rats, as compared to plasma derived AAT. RhAAT produced in cells co-expressing ST6 showed a decreased mean residence time as compared to plasma-derived AAT. 25 [0010] In one aspect, the present invention therefore provides recombinant human al -antitrypsin (rhAAT) comprising N-linked glycans, wherein: (a) at least 10% of said N-linked glycans are tetra-antennary glycans; and (b) the degree of capping with sialic acid on said N-linked glycans 30 (Z/A) is at least 50%.

WO 2010/127939 PCT/EP2010/055177 3 [0011] In another embodiment, at least 20% of said N-linked glycans are tetra antennary glycans. [0012] In a further embodiment, the degree of capping with sialic acid on said N linked glycans that are tetra-antennary is at least 30%. 5 [0013] In a further embodiment at least 50% of the total sialylation on said N linked glycans is a-2,3-sialylation. Preferably, at least 90% of the total sialylation on said N-linked glycans is a-2,3-sialylation. [0014] In a further aspect, the invention provides preparations and pharmaceutical compositions comprising said rhAAT, and optionally one or more pharmaceutically 10 acceptable excipients. [0015] In another aspect, the invention relates to the use of said rhAAT, preparations and/or pharmaceutical compositions, comprising said rhAAT, for the prevention and/or treatment of inter alia AAT-associated emphysema and/or inflammatory diseases with neutrophil-mediated tissue damage. 15 [0016] In a further embodiment, the invention provides a method for producing recombinant human al -antitrypsin, comprising the steps of providing a PER.C6 cell with a nucleic acid encoding human al-antitrypsin in such a way that said PER.C6 cell harbours said nucleic acid in an expressible form; and culturing said PER.C6 cell under conditions conducive to the production of said recombinant human AAT, wherein said 20 PER.C6 cell is modified to co-express a2,3 sialyltransferase or a2,6-sialyltransferase. BRIEF DESCRIPTION OF THE FIGURES [0017] FIG. 1. Frequency distribution of the specific productivities of the batch 25 cultures, both for cell lines overexpressing a2,3 sialyltransferase (A: PER.C6-AAT-ST3) and cell overexpressing a2,6-sialyltransferase (B: PER.C6-AAT-ST6). [0018] FIG. 2. 4-12% BIS-Tris SDS-PAGE gel with cell culture harvests of PER.C6-rAAT (non-purified) samples, stained with colloidal blue. [0019] FIG. 3. Schematic overview of the assay to determine the degree of 30 sialylation of the glycans on AAT by Z/A ratio.

WO 2010/127939 PCT/EP2010/055177 4 [0020] FIG. 4. Specific productivities of the PER.C6 cell lines expressing AAT are not correlated with the degree of sialylation of the glycans of PER.C6-rAAT (Spearman's r-0.024, p=0.893). (0: PER.C6-AAT-ST3; o: PER.C6-AAT-ST6). [0021] FIG. 5. Sialylation (Fig. 5A) and antennarity (Fig. 5B) of the glycans of 5 PER.C6-rAAT from ECL negative samples in comparison with the glycans of PER.C6 rAAT from ECL positive FIG samples and Prolastin*. [0022] FIG. 6. Degree of sialylation on all glycans (Fig. 6A) and on the tetra antennary glycans (Fig. 6B) of PER.C6-rAAT-ST3 in comparison with the glycans of PER.C6-rAAT-ST6 and Prolastin®. 10 [0023] FIG. 7. Plasma concentration-time profiles for various doses of Prolastin® in buffer (PBS/T) or in PER.C6-CM following i.v. bolus administration to rats. *: Prolastin@ in PER.C6-CM, 50 pg/kg; A: Prolastin@ in PER.C6-CM, 100 pg/kg: 0: Prolastin@ in PER.C6-CM, 200 pg/kg; o:Prolastin@ in PBS/T, 2000 pg/kg. [0024] FIG. 8. Plasma concentration-time profiles for PER.C6-rAAT-ST3, 15 PER.C6-rAAT-ST6 and Prolastin®. A: PER.C6-rAAT-ST3, MRT ~18-23 hr; m: PER.C6-rAAT-ST6, MRT -4-4 hr, e: Prolastin, MRT ~11-12 hr. [0025] FIG. 9. Plasmid maps of the AAT expression vectors pAATopt-ST3 (A) and pAATopt-ST6 (B). CMV=Cytomegalovirus promoter, BGHp(A)= Bovine Growth Hormone polyadenylation sequence, fl ori= fl origin of replication, SV40=Simian Virus 20 40 promotor, Neo=Neomycin resistance marker, SV40p(A)=Simian Virus 40 poly adenylation sequence, AAT= alpha -antitrypsin, ColE 1 =ColE 1 origin of replication, Amp=ampicillin resistance marker, SIAT4C=gene coding for ST3=human sialyltransferase IV (L23767) (Fig. 9A), SIAT 1=gene coding for ST6=human sialyltransferase I (NM_003032). 25 DETAILED DESCRIPTION OF THE INVENTION [0026] Alpha1-antitrypsin (AAT) is a natural inhibitor of proteases released by 30 activated neutrophils. AAT is secreted into the blood plasma but its primarily site of action is in the lung parenchyma. Human leukocyte elastase (HLE), (also known as WO 2010/127939 PCT/EP2010/055177 5 human neutrophil elastase (FINE) is a serine protease released from azurophilic granules of the neutrophils as part of the normal inflammatory response. Under normal homeostatic conditions AAT serves as an important regulator of proteolysis by human leukocyte elastase (HLE), thereby preventing damage of the lung alveolar matrix. Besides 5 HLE, AAT also inhibits two other proteases released into the lungs by neutrophils, namely cathepsin G (catG) and protease 3 (Pr3). [0027] Plasma-derived AAT products have been developed and are currently being used for the treatment of patients suffering from AAT-deficiency (i.e. having low or zero plasma AAT levels) related emphysema, such as Prolastin@, (Talecris), Aralast@ 10 (Baxter) and Zemaira® (ZLB). High amounts (approximately 60 mg/kg/ week) of this product are generally needed per patient. Besides emphysema, AAT is also a (potential) therapy for inflammatory diseases with neutrophil-mediated damage [0028] Recombinant production of AAT in for example E.coli has been hampered by low expression in most recombinant platforms (Kamaukhova et al., 2006). 15 Recombinant AAT has been produced at high level in transgenic systems, but clinical development thereof has been stopped because of suboptimal pharmacokinetics (PK) and safety issues due to non-human contaminants (Spencer et al., 2005). [0029] The present invention now provides a recombinant human al-antitrypsin (rhAAT) having suitable pharmacokinetic properties and that can be produced in large 20 quantities in for example PER.C6 cells. The recombinant AAT of the present invention has been shown to be functionally active, as determined by a chromogenic assay based on inhibition of human neutrophil elastase, and to have promising pharmacokinetic properties, as compared to plasma-derived AAT products, such as Prolastin*. [0030] The present invention thus provides rhAAT comprising N-linked glycans, 25 wherein a) at least 10% of said N-linked glycans are tetra-antennary glycans; and b) the degree of capping with sialic acid on said N-linked glycans (Z/A) is at least 50%. [0031] N-linked glycans are sugar chains that are covalently linked to asparagine 30 residues of a polypeptide (Varki et al. 1999). The process of N-glycosylation starts with the attachment of a dolichol oligosaccharide precursor to the asparagines precursor. This WO 2010/127939 PCT/EP2010/055177 6 precursor is subsequently modified into a high-mannose, hybrid, or complex-type oligosaccharide. In complex type N-linked sugars, both the 3- and u6-linked mannose residues are substituted by N-acetyl-glucosamine (GlcNAc) residues. Complex type N glycans may contain two to five GlcNAc-bearing branches that are referred to as 5 antennae. The ultimate structure of complex type N-linked sugars may vary extensively and depends on the protein to which they are attached, on the host cell and on the conditions under which the host cell is cultured. The GlcNAc-bearing branches may be modified with galactose (Gal) or N-acetyl-galactosamine (GalNAc) forming so-called LacNAc or LacdiNAc structures. Also, GlcNAc-bearing branches may contain multiple 10 LacNAc structures forming so-called polylactosamine structures. Terminal galactoses may be modified with an a2,3- or an a2,6-linked sialic acid whereas terminal N-acetyl galactosomines may only be modified with an a2,6-linked sialic acid. The addition of sialic acids to terminal Gal or GalNAc is mediated by sialyltransferases. Probably more than 20 different sialyltransferases are encoded by the human genome (Harduin-Lepers et 15 al., 2001). They differ in substrate specificity, tissue distribution and various biochemical parameters. [0032] Native AAT has three glycosylation sites. Thus, AAT comprises three N linked glycans in which branching can occur. These glycans may have 2,3 or 4 so-called "antennae" or branches. Surprisingly, it has been shown that at least 10%, preferably 20 from about 10% to about 50%, of said N-linked glycans of the rhAAT of the invention are tetra-antennary glycans. In another embodiment at least 20 % of said N-linked glycans are tetra-antennary glycans, preferably from about 20 to 40% of said N-linked glycans are tetra-antennary glycans. According to the present invention, it has surprisingly been shown that the glycosylation profile, for example in terms of 25 antennarity, as well as the pharmacokinetic properties, e.g. the mean residence time of the rhAAT of the invention differ from plasma-derived AAT, such as Prolastin@. [0033] Since full sialylation of the glycans on recombinant proteins is of importance for optimal pharmacokinetic properties, the rhAAT of the present invention is expressed in PER.C6 cells in combination with a sialyltransferase to achieve highly 30 sialylated isoforms of rhAAT. PER.C6 cells thus were co-transfected with either an a2,3 sialyltransferase (PER.C6-ST3) or an a2,6 sialyltransferase (PER.C6-ST6). In a WO 2010/127939 PCT/EP2010/055177 7 preferred embodiment of the invention at least 50% of the total sialylation on said N linked glycans is a-2,3-sialylation For example, at least 50, 70 or 80% of the total sialylation on said N-linked glycans is a-2,3-sialylation. In yet another embodiment at least 90% of the total sialylation on said N-linked glycans is a-2,3-sialylation. It has 5 surprisingly been shown that in these embodiments the rhAAT of the present invention has different pharmacokinetic properties, as compared to plasma-derived AAT, such as Prolastin@, in particular a prolonged mean residence time. By sialylation is meant the amount of sialic residues present on the AAT carbohydrate structures: a-2,3-sialylation means sialylation at the 2,3 position, i.e. an a2,3- linked sialic acid (as is well known in 10 the art) and a-2,6-sialylation means sialylation at the 2,6 position, i.e an or an u2,6-linked sialic acid (also known in the art). With "at least 50% of the total sialylation on said N linked glycans is a-2,3-sialylation", it is thus meant that at least 50% of the total number of sialic acid residues present in the rhAAT is sialylated in the 2,3 position. [0034] According to the invention it has been shown in PK studies in rat that the 15 mean residence time (MRT) of both rhAAT produced by PER.C6-ST3 (rhAAT-ST3) and rhAAT produced by PER.C6-ST6 (rhAAT-ST6) differs significantly from that of plasma derived AAT (Prolastin"). It has thus been shown that the MRT in rats of rhAAT-ST3 ranges from approximately 18-23 hours, whereas the MRT in rats of Prolastin* is approximately 11-12 hours. Using rhAAT having a prolonged MRT may for example 20 reduce the dosage needed per patient. In contrast, the MRT in rats of rhAAT-ST6 is reduced as compared to that of Prolastin" (approximately 3-4 hours). The use of rhAAT ST6 of the present invention may be advantageous due to the "more natural" 2,6-linkage of the sialic acid, which corresponds to the sialic acid linkage on plasma-derived AAT, such as Prolastin@. The use of rhAAT-ST6 may furthermore be advantageous in cases 25 where a reduced MRT may be beneficial. [0035] As stated above, the degree of sialylation of the glycans on recombinant proteins is of importance for optimal pharmacokinetic properties. In a preferred embodiment, the overall degree of capping with sialic acid on said N-linked glycans (as calculated by the Z/A ratio) of the rhAAT of the present invention therefore is at least 30 70%. More preferably, the degree of capping with sialic acid on said N-linked glycans WO 2010/127939 PCT/EP2010/055177 8 (Z/A) is at least 80%, even more preferably the degree of capping with sialic acid on said N-linked glycans (Z/A) is at least 90%. [0036] In a further embodiment, the degree of capping with sialic acid on said N linked glycans that are tetra-antennary is at least 20%, for example between 20% and 5 65%. A relatively low degree of sialylation on said tetra-antennary N-glycans may yield a rhAAT product having a reduced MRT, as compared to plasma derived AAT. In another embodiment, the degree of capping with sialic acid on said tetra-antennary N-linked glycans is at least 50%, for example between 50% and 97%, preferably at least 60%, more preferably between 70 and 95%. The higher level of sialylation in this embodiment 10 may contribute to the prolonged MRT, as compared to plasma derived AAT. [0037] The invention furthermore provides preparations and pharmaceutical compositions, comprising said rhAAT and optionally one or more pharmaceutically acceptable excipients. By "pharmaceutically acceptable excipient" is meant any inert substance that is combined with an active molecule (such as a drug, agent, or protein) for 15 preparing a suitable or convenient dosage form. The "pharmaceutically acceptable excipient" is an excipient that is non-toxic to recipients at the dosages and concentrations employed and is compatible with other ingredients of the formulation comprising the active molecule. [0038] The pharmaceutical compositions of the invention can be formulated into 20 various compositions for any route of administrations, well-known to the skilled person. The choice of the optimal route of administration of the pharmaceutical compositions will be influenced by several factors, including e.g. the physico-chemical properties of the active molecules within the compositions, the urgency of the clinical situation and the relationship of the plasma concentrations of the active molecules to the desired 25 therapeutic effect. The preparations and pharmaceutical compositions of the present invention are preferably formulated for intravenous administration or aerosol administration. Pharmaceutically suitable formulations of rhAAT can be prepared according to methods known to the person skilled in the art (see Remington's Pharmaceutical Sciences, 18th edition, A.R. Gennaro, Ed., Mack Publishing Company 30 (1990); Pharmaceutical Formulation Development of Peptides and Proteins, S. Frokjaer WO 2010/127939 PCT/EP2010/055177 9 and L. Hovgaard, Eds., Taylor & Francis (2000); and Handbook of Pharmaceutical Excipients, 3rd edition, A. Kibbe, Ed., Pharmaceutical Press (2000)). [0039] Typically, pharmaceutical compositions must be sterile and stable under the conditions of manufacture and storage. The preparations and/or pharmaceutical 5 compositions comprising the rhAAT of the invention can be in powder form for reconstitution in the appropriate pharmaceutically acceptable excipient before or at the time of delivery. In the case of sterile powders for the preparation of sterile injectable solutions, the preferred methods of preparation are vacuum drying and freeze-drying lyophilizationn) that yield a powder of the active ingredient plus any additional desired 10 ingredient from a previously sterile-filtered solution thereof. [0040] Alternatively, the rhAAT of the present invention can be in solution and the appropriate pharmaceutically acceptable excipient can be added and/or mixed before or at the time of delivery to provide a unit dosage injectable form. [0041] The rhAAT, the preparations or pharmaceutical compositions, comprising 15 said rhAAT, can be used as medicaments. The rhAAT, the preparations and pharmaceutical compositions can be suitably used in the prevention and/or treatment of diseases and/or disorders for which the administration of AAT has been proven beneficial. They can inter alia be used in the prevention and/or treatment, or combination thereof, of AAT-deficiency-associated emphysema. The rhAAT, preparations or 20 pharmaceutical compositions of the present invention can further be used in the prevention and/or treatment of smoking-related emphysema, cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD). Since AAT has been described to have anti inflammatory and antiapoptotic effects, the rhAAT, preparations or pharmaceutical compositions of the present invention may also be used as anti-inflammatory agents. 25 (Lewis et al., 2008; Koulmanda et al., 2008) [0042] In a further embodiment, the invention provides a method for producing recombinant human al -antitrypsin, comprising the steps of providing a PER.C6 cell with a nucleic acid encoding human al-antitrypsin in such a way that said PER.C6 cell harbors said nucleic acid in an expressible form; and culturing said PER.C6 cell under 30 conditions conducive to the production of said recombinant human al-antitrypsin, wherein said cell further contains a nucleic acid sequence encoding a sialyltransferase, WO 2010/127939 PCT/EP2010/055177 10 preferably an alpha-2,6-sialyltransferase or an alpha-2,3-sialyltransferase, under control of a heterologous promoter. In an embodiment, the sialyltransferase is a human sialyltransferase. The rhAAT of the present invention may, however, also be produced in other mammalian cells, optionally co-expressing a sialyltransferase, such as for example 5 293 cells. [0043] In an embodiment, the invention provides a method for producing recombinant human al -antitrypsin, comprising the steps of providing a PER.C6 cell with a nucleic acid encoding human al-antitrypsin in such a way that said PER.C6 cell harbors said nucleic acid in an expressible format, wherein said cell further contains a 10 nucleic acid sequence encoding a sialyltransferase, preferably an alpha-2,6 sialyltransferase or an alpha-2,3-sialyltransferase, under control of a heterologous promoter; culturing said PER.C6 cell in a serum-free medium and allowing expression of said human al-antitrypsin in said cell; harvesting the expressed human al-antitrypsin from said cell and/or from said culture medium; and optionally purifying said human al 15 antitrypsin. [0044] The use of PER.C6 cells as a production platform for proteins of interest has been described in WO 00/63403 the disclosure of which is incorporated herein by reference. As shown in WO 00/63403, PER.C6 can be suitably used for the production of recombinant proteins. In order to achieve large-scale (continuous) production of 20 recombinant proteins through cell culture, it is preferred to have cells capable of growing without the necessity of anchorage. The cells of the present invention have that capability. A PER.C6 cell according to this invention is a cell from an upstream or downstream passage or a descendent of an upstream or downstream passage of cells as deposited at the Center for Applied Microbiology and Research & European Collection 25 of Cell Cultures (ECACC) on 29 February 2006 under ECACC no. 96022940 (see, e.g., U.S. Patent 5,994,128). The use of PER.C6 cells for industrial processes has been extensively described, e.g. in Nichols et al, 2002, and more in particular for recombinant protein production, e.g. in Yallop et al, 2005a and 2005b. [0045] The cells according to the invention, in particular PER.C6 cells, have the 30 additional advantage that they can be cultured in the absence of animal- or human derived serum or animal- or human-derived serum components. Thus isolation is easier, WO 2010/127939 PCT/EP2010/055177 11 while the safety is enhanced due to the absence of additional human or animal proteins in the culture, and the system is very reliable (synthetic media are the best in reproducibility). Furthermore, the presence of the Early region 1A ("E1A") of adenovirus adds another level of advantages as compared to (human) cell lines that lack this 5 particular gene. E1A as a transcriptional activator is known to enhance transcription from the enhancer/promoter of the CMV Immediate Early genes (Olive et al., 1990, Gorman et al., 1989). When the recombinant protein to be produced is under the control of the CMV enhancer/promoter, expression levels increase in the cells and not in cells that lack ElA. [0046] In general, the production of a recombinant protein, such as rhAAT, in a 10 host cell, such as a PER.C6 cell, comprises the introduction of nucleic acid in expressible format into the host cell, culturing the cells under conditions conducive to expression of the nucleic acid and allowing expression of the said nucleic acid in said cells. Alternatively, a protein that is naturally expressed in desired host cells, but not at sufficient levels, may be expressed at increased levels by introducing suitable regulation 15 sequences such as a strong promoter in operable association with the desired gene (see e.g. WO 99/05268, where the endogenous EPO gene is over-expressed by introduction of a strong promoter upstream of the gene in human cells). [0047] Nucleic acid encoding AAT in expressible format may be in the form of an expression cassette, and usually requires sequences capable of bringing about 20 expression of the nucleic acid, such as enhancer(s), promoter, polyadenylation signal, and the like. Several promoters can be used for expression of recombinant nucleic acid, and these may comprise viral, mammalian, synthetic promoters, and the like. In certain embodiments, a promoter driving the expression of the nucleic acid of interest is the CMV immediate early promoter, for instance comprising nt. -735 to +95 from the CMV 25 immediate early gene enhancer/promoter, as this promoter has been shown to give high expression levels in cells expressing ElA of an adenovirus (see e.g. WO 03/051927). The nucleic acid of interest may be a genomic DNA, a cDNA, synthetic DNA, a combination of these, etc. [0048] Cell culture media are available from various vendors, and serum-free 30 culture media are nowadays often used for cell culture, because they are more defined than media containing serum. The cells of the present invention grow well in serum- WO 2010/127939 PCT/EP2010/055177 12 containing media as well as in serum-free media. The cells of the invention in general grow adherently in serum-containing media, but are very proficient in growing in suspension to high cell densities (1 OxI 06 cells/ml and higher) in serum-free culture media, which means that they do not need a surface to adhere to, but remain relatively 5 free from each other and from the walls of the culture vessel during most of the time. Processes for culturing the cells of the invention to high densities and/or for obtaining very high product yields from these cells have been described (WO 2004/099396). [0049] The concept of genetic engineering to alter glycosylation of recombinant proteins produced in a cell has been amply established, and is for instance discussed in 10 detail in e.g US 2005/0164386. To this purpose, nucleic acid encoding the desired glycosylation enzyme in expressible format is or has been introduced into the cells according to the invention, and the desired glycosylation enzyme is expressed during the culturing of the cells according to the invention when the protein of interest is expressed. This results in an altered glycosylation pattern of the protein of interest as compared to 15 the situation when no recombinant glycosylation enzyme is expressed in the cells. In the present invention, the glycosylation enzyme is a sialyltransferase, more preferred an alfa 2,3-sialyltransferase and/or an alfa-2,6-sialyltransferase. Preferably, the encoded sialyltransferase is a mammalian sialyltransferase, more preferably a human sialyltransferase. The nucleic acid encoding the sialyltransferase preferably is under 20 control of a heterologous promoter, which should be active or have the possibility of being regulated in the cells of the invention. Preferably, the nucleic acid encoding the sialyltransferase is integrated into the genome of the cells, to ensure stable inheritance, and provide for stable expression of the sialyltransferase in subsequent generations of the cells. 25 [0050] The invention furthermore provides recombinant human AAT, obtainable by the methods according to the invention. According to the invention the rhAAT has a human glycosylation pattern different from the isolated natural human counterpart protein. The present invention in particular provided rhAAT comprising N-linked glycans, wherein at least 10% of said N-linked glycans are tetra-antennary glycans. In 30 addition, the rhAAT obtainable according to the present invention has surprising pharmacokinetic properties.

WO 2010/127939 PCT/EP2010/055177 13 [0051] Recombinant human AAT according to the invention includes full-length human AAT, but also may encompass biologically active polypeptide fragments, such as fragments of human AAT with one or more amino acid deletions at e.g. the N-terminus of the protein, as well as biologically active variants of human AAT, such as AAT with one 5 or more amino acid substitutions (e.g. conservative substitutions), one or more deletions or additions of amino acids, which do not significantly change the functional activity of the protein. In an embodiment, the rhAAT of the present invention comprises an amino acid sequence provided herein as SEQ ID NO: 1. In some embodiments, amino acid sequences of AAT variants are at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 10 98% or 99% homologous to SEQ ID NO:1. [0052] The present invention is further illustrated by the following non-limiting examples. EXAMPLES 15 EXAMPLE 1 Cell line generation and specific productivities [0053] Seven hundred PER.C6 cell lines expressing human AAT and co 20 expressing either an a2,6-sialyltransferase (SIATI; NM_003032) or an a2,3 sialyltransferase (SIAT4C; L23767) (PER.C6-AAT-ST3/ PER.C6-AAT.ST6) were generated under serum-free conditions, as described in WO 2006/070011. Forty-seven serum-free PER.C6 cell lines producing either AAT-ST3 (27 cell lines) or AAT-ST6 (20 cell lines) were selected based on highest yield as determined by ELISA (AAT Elisa Kit, 25 US Biologicals) from independent cell line generation programs using nucleofection as transfection tool. The expression plasmid contained the coding sequence for human AAT (SEQ ID NO:2) and the coding sequence for human ST3GalIV, both driven by a cytomegalovirus promoter that has been modified to achieve high levels of gene expression in PER.C6 cells (Yallop et al, 2005). The plasmid maps of the AAT 30 expression vectors (pAATopt-ST3 and pAATopt-ST6) are shown in Figure 9.

WO 2010/127939 PCT/EP2010/055177 14 [0054] The productivity of the cell lines varied between 8-22 picogram per cell per day (pcd) (PER.C6-AAT-ST3) and 7-19 pcd (PER.C6-AAT-ST6) (see Figure 1 and Tables 1 and 2). The cell lines were cryo-preserved in Proper-I medium (Lonza) (6 vials, 3-5x10 6 cells/ml), meeting all acceptance criteria (viability > 80%, good growth two 5 passages post resuscitation). Batch cultures were generated (in Proper-i medium), which were used for biochemical analysis (see Example 2). EXAMPLE 2 Biochemical analysis 10 [0055] Integrity of PER.C6-rAAT The supernatants of the 47 batch cultures were analyzed on SDS-PAGE stained with colloidal blue. Cell culture harvest of the PER.C6-rAAT (non-purified) samples showed AAT as the main protein band on SDS-PAGE. Furthermore, the gels showed 15 intact AAT bands (shown in Figure 2) indicating the integrity of the material. [0056] Activity of PER.C6-rAAT Initially (in lieu of a chromogenic activity assay), an indication for activity was determined by analyzing the formation of a complex of PER.C6-rAAT with human 20 neutrophil elastase. To this end, cell culture harvests of PER.C6-rAAT samples were incubated with 0, 0.1, 0.2 and 0.4 pg elastase for 30 min at 37'C and subsequently applied on a 4-12% BIS-Tris SDS-PAGE and stained with colloidal blue). All PER.C6 rAAT samples tested formed a complex with elastase (data not shown), indicating activity of the preparations. Further activity testing was done with a chromogenic assay 25 based on inhibition of human neutrophil elastase using Prolastin* as reference (adapted from Bruin et al., 2005)). All PER.C6-rAAT samples tested, except for one (PER.C6 rAAT-ST3-234c), were at least as active as Prolastin" (>90%) (Tables 1 and 2). [0057] Glycan analysis of PER.C6-rAAT 30 To screen for PER.C6-rAAT samples of which the glycans have a relative high degree of capping with sialic acid, needed for an optimal PK profile, a lectin assay was WO 2010/127939 PCT/EP2010/055177 15 applied, using Erythrina cristagalli lectin (ECL) for detection of exposed galactoses (see Figure 3 for a schematic overview of the used assay).From the 47 samples tested 15 showed a signal at OD405 with ECL > blank + 0.2, indicating a relatively high degree of exposure of terminal galactoses on the glycans of these AAT samples. For a few of these 5 samples the low degree of capping of the glycans by sialic acid was confirmed by further glycan analysis using an HPLC-based method (Hermentin et al., 1996; Gervais et al., 2003). Therefore, the rhAAT samples with an ECL signal at OD405 > blank + 0.2 were not further subjected to extended glycan analysis and not tested in PK studies. [0058] The extended glycan profiling method is schematically shown in Figure 3 10 and involves the release of the N-linked glycans from AAT with the enzyme N glycosidase F (PNGaseF), and labelling the glycans with fluorescent 2-anthranilic acid (2-aa). Subsequently, the glycans are separated by anion exchange chromatography (AEX) into groups according to their negative charge, i.e. separation of glycans with different numbers of sialic acid. From this profile a Z-number, representing the degree of 15 charge (i.e. sialylation) of the N-linked glycans, is determined. The formula for Z: Z = (AAsialoxO)+(AMonosialox1)(ADisiaiox 2 )+(ATrisiaiox 3 )+(Aretrasiaiox 4 ) (A= area, Hermentin et al., 1996). 20 [0059] Furthermore, the desialylated glycans are separated by normal phase chromatography (NP) into groups according to their size, i.e. separation of glycans with different degree of branching (antennarity). From this profile an A-number, representing the degree of branching of the N-linked glycans, is determined. 25 The formula for A: A = (ADiantennaryx 2 )+(ATriantemaryx 3 )+(ATetra-antennaryx 4 ). [0060] Finally, by calculating the Z/A ratio, the degree (percentage) of capping by 30 sialic acid of the N-linked glycans of a glycoprotein is obtained (Gervais et al., 2003).

WO 2010/127939 PCT/EP2010/055177 16 [0061] The glycan profiles of PER.C6-rAAT are shown in Tables 1 and 2. The overall profiles of PER.C6-rAAT samples (Tables 1 and 2) show 12-54% di-antennae, 13-39% tri-antennae and 22-48% tetra-antennae and 0-55% di-sialo, 0-30% tri-sialo, 0 29% tetra-sialo. The degree of capping of the glycans by sialic acid of PER.C6-rAAT 5 ranges from 0 to 92%, this degree of capping with sialic acid is not correlated with the specific productivities of the PER.C6-rAAT cell lines (Spearman's r--0.024, p=0.893) (Tables 1 and 2 and Figure 4). [0062] As expected the glycans the ECL positive rAAT contain a lower level of charge (sialylation) (Z-number range: 0-124) versus the ECL negative PER.C6-rAAT (Z 10 number range: 151-253) (difference is significant as tested by the Mann-Whitney test, p<0.001) (see Figure 5). The glycans of ECL-positive PER.C6-rAAT contain a higher level of antennarity (A-number range: 299-322) versus the ECL-negative PER.C6-rAAT (A-number range: 266-307) (difference is significant as tested by the Mann-Whitney test, p<0.001) (see Figure 5). Furthermore, there is a lower degree of sialylation on the tetra 15 antennary glycans of PER.C6-rAAT-ST6 (ECL negative), ranging from 6 to 62% versus PER.C6-rAAT-ST3 (ECL negative), ranging from 35 to 106% (difference is significant as tested by the Mann-Whitney test, p<0.001), while this is not the case for the overall degree of sialylation (Tables 1 and 2, Figure 6). The lower preference of ST6 for higher branched glycans (Joziasse et al., 1987) may be the cause of the lower degree of 20 sialylation on the tetra-antennary glycans of PER.C6-rAAT-ST6 versus PER.C6-rAAT ST3. [0063] The glycan profiles indicate a tendency for a higher degree of branching on the glycans of PER.C6-rAAT in comparison to plasma derived AAT (Prolastin*), as the profile for Prolastin* is: 80% di-antennae, 18% tri-antennae and 2% tetra-antennae 25 (Tables 1 and 2). This phenomenon is also clear from comparison of the A-numbers (Figure 5 and Tables 1 and 2). The degree of capping of the glycans by sialic acid of Prolastin" is 96% (Tables 1 and 2).

WO 2010/127939 PCT/EP2010/055177 17 EXAMPLE 3 Pharmacokinetics of PER.C6-rAAT in a rat model [0064] A rat model was established to determine the pharmacokinetics (PK) of 5 PER.C6-rAAT. The model should be able to detect AAT present in unpurified PER.C6 conditioned medium (CM) at concentrations of about 40-100 pg/mL (at 2 mL/kg resulting in doses of about 80-200 pg/kg). [0065] Four experiments were performed: the first two to set-up the model and the second, third and fourth experiments to select the PER.C6-rAAT cell lines producing 10 rAAT with most optimal PK characteristics. In these studies, human pdAAT (Prolastin*) was used to establish the model and as reference. The experimental procedure was as follows: rats (male Wistar, age 8 weeks) were dosed i.v. in the tail vein with the AAT test samples (dose volume 2 ml/kg, dose range 50-200 pg/kg, n=3 rats per group). Blood was sampled from the tail tip pre-dose and at various time points following dose 15 administration. The blood was collected in K 2 EDTA microvettes and plasma was prepared. The residual AAT concentration in the plasma samples was subsequently determined by ELISA (AAT Elisa Kit, Affinity Biologicals). The data obtained were modelled per rat with a 2-compartment model and PK parameters were subsequently determined. 20 [0066] As shown by the data from experiment 1 (see Figure 7) the model was found suitable to determine the PK profile in unpurified samples because the plasma concentration versus time curves of Prolastin* spiked in PER.C6-CM and buffer control (PBS, 0.01% w/v Tween-80 (PT) (doses 200 pg/kg) are similar. A similar result was found with Prolastin* doses of 100 pg/kg (data not shown). In Figure 7 it is also shown 25 that an increased response is observed with doses of Prolastin* spiked in CM from 50 200 pg/kg. From the data it was calculated that Prolastin® has a mean residence time (MRT) of 11-12 hr. Also the PER.C6-rAAT samples were detected, with PER.C6-rAAT ST3-202c showing a slower clearance (MRT ~ 20.5 hr) as compared to Prolastin® and PER.C6-rAAT-ST6-530 showing a faster clearance (MRT ~3.6 hr) compared to 30 Prolastin® (Table 1 and 2). Based on these observations, it was therefore concluded that the model could be used for the unpurified PER.C6-rAAT samples, which were tested in WO 2010/127939 PCT/EP2010/055177 18 experiments 2-4 at a dose level of 100 pg/kg for all samples. In Figure 8 representative PK profiles for PER.C6-rAAT-ST3 and PER.C6-rAAT-ST6 in comparison to Prolastin* are shown. [0067] The last column in Tables 1 and 2 shows the MRT values obtained in the 5 PK experiments. Statistical testing on differences between samples and groups of samples with regard to the MRT was done by ANOVA on log transformed values. The MRTs of both the PER.C6-rAAT-ST3 and PER.C6-rAAT-ST6 preparations tested were significantly different from that of Prolastin". The MRT for 8 out of 10 PER.C6-rAAT ST3 preparations tested were significantly higher than that of Prolastin* and ranged from 10 18-23 hr. Between these 8 PER.C6-rAAT-ST3 preparations the differences in MRT were not significant. [0068] The MRTs of PER.C6-rAAT-ST3-053b and -539 were significantly lower than that of Prolastin*. For PER.C6-rAAT-ST3-0539 this is due to the relatively low degree of sialylation (49%) as confirmed by the rescue of the PK profile of this 15 preparation in the first hour during blocking of the asialoglycoprotein receptor by co injection with asialofetuin (data not shown). The glycan profile for PER.C6-rAAT-ST3 053b was inconclusive (no clear peak assignments possible), however, also in this case undersialylation is most likely the cause of the low MRT. [0069] For all PER.C6-rAAT-ST6 preparations tested the MRT was significantly 20 lower than that of Prolastin® ranging from 3.4-3.9 hr. This may be explained by the relative low degree of sialylation of the tetra-antennary glycans on PER.C6-rAAT-ST6 (ranging from 6 to 62%) and/or by a potential different mechanism of clearance for a2,3 sialylated AAT versus a 2,6 sialylated AAT. 25 [0070] Conclusions According to the present invention PER.C6 cell lines have been generated that produce human AAT with a high yield (up to 22 pcd) and with an acceptable quality, i.e. the preparations were active in an in vitro assay. Surprisingly and interestingly, promising PK profiles were demonstrated in a rat model. PER.C6 cells thus form a suitable platform 30 for the production of human recombinant AAT for use in inter alia AAT-deficiency related emphysema or for use in other inflammatory diseases with neutrophil-mediated WO 2010/127939 PCT/EP2010/055177 19 tissue damage. The rhAAT of the present invention may however also suitably be produced in other mammalian cell types co-expressing a 2,3- or 2,6-sialyltransferases.

WO 2010/127939 PCT/EP2010/055177 20 cie a a c-a LL Wi-i~~ c-) (Na)c D c i r--- oo oo r-- ocoo r C c 7) 0 N o o in in Ic 2 co c -- - (-O - o -o o'i i c) to r o c - CAL c 0[ CO C L CD (- I aa )a ar- a c 4 a r-- 1:11 -,A Is c aLDo 6i 6c- VIn 6 & ciQ Fin yc aaoinL oac ant LM M OC W C I- M a) In Co O Rr 1- In -- o-doe 0 L - _ o- in mo oaoL-oAo os N .5j V m u, O Q vO G3 We m O 2 ,;! 2 ~ l Cli C-4 Cl Coa oci i - N i - N c- - - Co - - n- 4- 4: oo 0oco) - 3o 3 3 d4 m ci- o a n - -rlo -cc- -- elc-- cc-aa in C( C I - C IN OC aoia cic ix o l c c C I-mO a a a a a o a a Caciao a a - oo o C aci to aa coo> mo 6& o is acin a- Ici L a .2. A2 -y) CD -- -c -c aa T a IT CD - c c c -o o ci o-- ,o o> 6 'T 'n e )'T C411-l)C4n ' Tl, a- a a -ADi a - m-A >-L7) C4 QC)Q 4 0 in -a' a aci a D - e--- -- C-I----- -- aA a nn 8 .0 t CO ' CD ke( a j- _7 c.) E .3 uD uo 'T uT 0)au uu a a oo a u o. w NI m w w PD IO- NT w WT CD4 ID 00 a) 004 OA C_ w1 wI-m o w .-w 1 Qa l E"' n C= ciciaciciaaciciciciciaaci cia ci- a -i a,- m CF CD- ciiiiiiicccccccciii a cc CI N I N ( I )IY 1 o C~ cNaciaPa'D cia(- aci(D aa AD)aa N Ut ciiiiiiccc-=iii i c - 'A cic in CD C) ) C46' r cca nC-aac~ x AD) aD ao IaT CD jC' a-4ia i ciia ciia --- a - -7 cii, : 'Ut AaA~aAacv~c-i~A~-i~a~ cci - cic ca 6d T -T -T p- 3n o3 CC2 C(' CD C F CAcD I I 6F 4 031 -c' mt-m t)0 CD~( CD')' rD(H 03100 t:10 CD 0 03 C)00 M30 U) 0 C' r v *~~w : uJ00C IOD W C C1ICUCJ to0oh(o ) c) Wc rip[DL - 10 inc q )mV anU A4 0 l , WO 2010/127939 PCT/EP2010/055177 21 m mImT <D o D o ' :To oc -T :T n - < )D ic co co r-- r- in co co r-- co 0 o r COON-LCin to CO CO AO C CT E co Im w oC o : - co C) - ) to N NlT ' coJ Io Co C CqN NNN 1 LO COD M CD 0 CI , oD 0 -N U sonaoaNc d C o o LO o O A o r--O C-4 to in 0) -A CD D n ot cT m C-) -2 c - - C= oO AA C146 6N n (-i ~N. (N CD C 0 o- o A2 C) 0 r ninCO co c CO InD T L In n6 6 ace m-a L - n 01 a c Ft 0 cj- C _- a 1a- c C c CNt 00 XC (D -l C c0i a- - c C i= aO c ( (D oC ot a a a ) a CD a 'o- ci [ oa- a co oint00 4')c- a D_ v w C t av c co P- oc C a o co o-aa i. crC0 o nt- oN oAo- a o r C 0 o -co to a o o Ta 3 - o -m a CO "A (D O- LD 0) (D 1 -aCvo t-CL o c01 CcO nm a o InD a cc 1-* O - -a- - r h-- a n a- C -i g . - s= K- o o 9 rO cc C , o a aa-- n xar-ta a t-0c- o in | - - I- - - - - - - - - - - - -- -- - - -- --6F LC - E k H ) u (D)-'" oa o o CO CA LD r- oD o- Cn of co) o C c H D il i- ao Dr - ) - c - 0 1 - - o a a O D o r 0 c-ccc. -aa o e - - K c - - - - =- a Dc or-- -- -- n--- -- 9 -- e1 "0 u a-tac-e- a a £ o - i 4d 0 C, 0~ ot 0ei oo C) C awL. o 0 02 02 WO 2010/127939 PCT/EP2010/055177 22 SEQ ID NO: 1 Amino acid sequence of AAT 5 Mpssvswgilllaglcclvpvslaedpqgdaaqktdtshhdqdhptfnkitpnlaefafs lyrqlahqsnstniffspvsiatafamlslgtkadthdeileglnfnlteipeaqihegf qellrtlnqpdsqlqlttgnglflseglklvdkfledvkklyhseaftvnfgdteeakkq indyvekgtqgkivdlvkeldrdtvfalvnyiffkgkwerpfevkdteeedfhvdqvttv 10 kvpmmkrlgmfniqhckklsswvllmkylgnataifflpdegklqhlenelthdiitkfl enedrrsaslhlpklsitgtydlksvlgqlgitkvfsngadlsgvteeaplklskavhka vltidekgteaagamfleaipmsippevkfnkpfvflmieqntksplfmgkvvnptqk* SEQ ID NO: 2 15 Optimized CDS of AAT (based on NM_000295) atgcccagcagcgtgagctggggcatcctgctgctggccggcctgtgctgcctggtgccc gtgagcctggccgaggacccccagggcgacgccgcccagaaaaccgacaccagccaccac gaccaggaccaccccaccttcaacaagatcacccccaacctggccgagttcgccttcagc 20 ctgtaccggcagctggcccaccagagcaacagcaccaacatctttttcagccccgtgagc atcgccaccgccttcgccatgctgtccctgggcaccaaggccgacacccacgacgagatc ctggaaggcctgaacttcaacctgaccgagatccccgaggcccagatccacgagggcttc caggaactgctgcggaccctgaaccagcccgacagccagctccagctcaccaccggcaac ggcctgtttctgagcgagggcctgaaactggtggacaagtttctcgaagatgtgaagaag 25 ctgtaccacagcgaggccttcaccgtgaacttcggcgacaccgaggaagccaagaagcag atcaacgactacgtggagaagggcacccagggcaagatcgtggacctggtgaaagagctg gaccgggacaccgtgttcgccctggtgaactacatcttcttcaagggcaagtgggagcgg cctttcgaggtgaaggataccgaggaagaggacttccacgtggaccaggtgaccaccgtg aaggtgcccatgatgaagcggctgggcatgttcaacatccagcactgcaagaagctgtcc 30 agctgggtcctgctgatgaagtacctgggcaacgccaccgccatcttttttctgcccgac gagggcaagctgcagcacctggaaaacgagctgacccacgacatcatcaccaagtttctg gaaaatgaggaccggcggagcgccagcctgcacctgcccaagctgtccatcaccggcacc tacgacctgaagagcgtgctgggccagctgggcatcaccaaggtgttcagcaacggcgcc gacctgagcggcgtgaccgaagaggcccccctgaagctgtctaaggccgtgcacaaggcc 35 gtgctgaccatcgacgagaaggggaccgaagccgccggagccatgtttctggaagccatc cccatgagcatcccccccgaggtgaagttcaacaagcccttcgtgttcctgatgatcgag cagaacaccaagagccccctgttcatgggcaaggtggtgaaccccacccaaaagtga WO 2010/127939 PCT/EP2010/055177 23 REFERENCES A Gervais, YA Hammel, S Pelloux, P Lepage, G Baer, N Carte, 0 Sorokine, JM Strub, R Koerner, E Leize and A Van Dorsselaer. 2003. Glycosylation of human recombinant gonadotrophins: characterization and batch-to-batch consistency. 5 Glycobiology, 13: 179-189. P Hermentin, R Witzel, EJ Kanzy, G Diderich, D Hoffmann, H Metzner, J Vorlop and H Haupt. 1996. The hypothetical N-glycan charge: a number that characterisizes protein glycosylation. Glycobiology, 6: 217-230. 10 DH Joziasse, WE Schiphorst, DH Van den Eijnden, JA Van Kuik, H Van Halbeek and JF Vliegenthart. 1987. Branch specificity of bovine colostrum CMP-sialic acid: Gal beta 1-4GlcNAc-R alpha 2-6-sialyltransferase. Sialylation of bi-, tri-, and tetraantennary oligosaccharides and glycopeptides of the N- acetyllactosamine type. J. Biol. Chem. 262: 15 2025-2033. E Karnaukhova, Y. Ophir and B. Golding. 2006. Recombinant human alpha-i proteinase inhibitor: towards therapeutic use. Amino Acids 30: 317-332. 20 AT Mulgrew, CC Taggart and NG McElvaney. 2007. Alpha-1-Antitrypsin Deficiency-Current Concepts. Lung 185: 191-201. TL Spencer, JE Humphries and ML Brantly. 2005. Antibody Response to Aerosolized Transgenic Human Alphal Antitrypsin NEJM 352: 30-31. 25 CA Yallop, J Crowley, J Cote, K Hegmans-Brouwer, F Lagerwerf, R Gagne, JC Martin, N Oosterhuis, DJ Opstelten and A Bout. 2005a. PER.C6 cells for the manufacture of biopharmaceutical proteins. In "Modem Biopharmaceuticals. Volume 3. Design, Development and Optimization", pp 779-807. Wiley-VCH, Germany. 30 WO 2010/127939 PCT/EP2010/055177 24 C. Yallop, M. Raadsman, M. Zuiderwijk, Y. Van Noordenburg, A. Vooys, R. Keehnen, B. Van Montfort, M. Jansen, F. Lagerwerf, R. Dijkstra and others. 2005b. High level production of recombinant IgG in the human cell line PER.C6. In: Godia F. Fussenegger M., editors. Animal cell technology meets genomics: Springer. P. 533-536. 5 E.C. Bruin, D. Roem, I. Bulder, M. Dicker, G. Voerman, C.E. Hack. 2005. Production, purification and characterisation of recombinant Fahsin, a novel antistasin type proteinase inhibitor. FEMS Yeast Res. 5(11): 1069-1077. 10 A. Varki, R Cummings, J. Esko, H. Freeze, G. Hart, J. Marth. 1999. Essentials of glycobiology. Cold Spring Harbor Laboratory Press, Cold Spring Harbor, N.Y., USA. A. Harduin-Lepers, V. Vallejo-Ruiz, Krzewinsky-Recchi Mass., B. Samyn-Petit, S. Julien, P. Delannoy. 2001. The human sialyltransferase family. Biochimie 83: 727 15 737. E.C. Lewis, M. Mizrahi, M. Toledano, N. DeFelice, J.L. Wright, A. Churg, L. Shapiro, C.A. Dinarello. 2008. al-Antitrypsin monotherapy induces immune tolerance during islet allograft transplantation in mice. PNAS 105: 16236-16241. 20 M. Koulmanda, M. Bhasin, L. Hoffman, Z. Fan, A. Qipo, H. Shi, S. Bonner-Weir, P. Putheti, N. Degauque, T.A. Libermann, H. Auchincloss, Jr., J.S. Flier, T.B. Strom. 2008. Curative and P cell regenerative effects of al-antitrypsin treatment in autoimmune diabetic NOD mice. PNAS 105: 16242-16247. 25 W.W. Nichols, R. Lardenoie, B.J. Ledwith, K. Brouwer, S. Manam, R. Vogels, D. Kaslow, D. Zuidgeest, A.J. Bett, J. Chen and others. 2002. Propagation of adenoviral vectors: use of PER.C6 cells. In: Curiel D. Douglas J.T. editors. Adenoviral vectors for gene therapy. San Diego: Elsevier. P. 129-167. 30 WO 2010/127939 PCT/EP2010/055177 25 D.M. Olive, W. Al-Mulla, M. Simsek, S. Zarban, W. al-Nakib. 1990. The human cytomegalovirus immediate early enhancer-promotor is responsive to activation by the adenovirus-5 13S ElA gene. Arch. Virol. 112: 67-80. 5 C.M. Gorman, D. Gies, G. McGray, M. Huang. 1989. The human cytomegalovirus major immediate early promoter can be transactivated by adenovirus early proteins. Virology 171: 377-385.

WO 2010/127939 PCT/EP2010/055177 1/1 PCT Print Out (Original in Electronic Form) (This sheet is not part of and does not count as a sheet of the international application) 0-1 Form PCT/RO/134 (SAFE) Indications Relating to Deposited Microorganism(s) or Other Biological Material (PCT Rule 13bis) 0-1-1 Prepared Using PCT Online Filing Version 3.5.000.219 MT/FOP 20020701/0.20.5.9 0-2 International Application No. 0-3 Applicant's or agent's file reference 0169WOO OORD 1 The indications made below relate to the deposited microorganism(s) or other biological material referred to in the description on: 1-1 page 10 1-2 line 25 1-3 Identification of deposit 1-3-1 Name of depositary institution ECACC European Collection of Cell Cultures 1-3-2 Address of depositary institution Health Protection Agency - Porton Down, Salisbury, Wiltshire SP4 OJG, United Kingdom 1-3-3 Date of deposit 29 February 1996 (29.02.1996) 1-3-4 Accession Number ECACC 96022940 1-5 Designated States for Which All designations Indications are Made FOR RECEIVING OFFICE USE ONLY 0-4 This form was received with the international application: yes (yes or no) 0-4-1 Authorized officer Rossi, Cinzia FOR INTERNATIONAL BUREAU USE ONLY 0-5 This form was received by the international Bureau on: 0-5-1 Authorized officer

Claims (15)

1. Recombinant human al-antitrypsin (rhAAT) comprising N-linked glycans, characterized in that: 5 (a) at least 10% of said N-linked glycans are tetra-antennary glycans; and (b) the degree of capping with sialic acid on said N-linked glycans (Z/A) is at least 50%.

2. RhAAT according to claim 1, wherein at least 20% of said N-linked glycans are 10 tetra-antennary glycans.

3. RhAAT according to claim 1 or 2, wherein from about 10% to 50% of said N linked glycans are tetra-antennary glycans. 15

4. RhAAT according to claim 1 or 2, wherein from about 20% to 40% of said N linked glycans are tetra-antennary glycans.

5. RhAAT according to any one of the claims 1-4, wherein at least 50% of the total sialylation on said N-linked glycans is a-2,3-sialylation. 20

6. RhAAT according claim 5, wherein at least 9 0% of the total sialylation on said N-linked glycans is a-2,3-sialylation.

7. RhAAT according to any one of the preceding claims, wherein the degree of 25 capping with sialic acid on said N-linked glycans (as calculated by the Z/A ratio) is at least 70%, preferably at least 8 0%, more preferably at least 90 %.

8. RhAAT according to any one of the preceding claims, wherein the degree of capping with sialic acid on said N-linked glycans that are tetra-antennary is at least 20%. 30 WO 2010/127939 PCT/EP2010/055177 27

9. RhAAT according to any one of the preceding claims, wherein the degree of capping with sialic acid on said N-linked glycans that are tetra-antennary is at least 50%.

10. RhAAT according to claim 9, wherein the degree of capping with sialic acid on 5 said N-linked glycans that are tetra-antennary is from about 50% to about 97%.

11. RhAAT according to any one of the preceding claims, wherein the degree of capping with sialic acid on said N-linked glycans that are tetra-antennary is from about 70% to about 95%. 10

12. RhAAT according to any one of the preceding claims for use as a medicament.

13. RhAAT according to any one of the preceding claims for use in the prevention and/or treatment of a disease associated with AAT deficiency, and/or a disease involving 15 neutrophil-mediated tissue damage.

14. Method for producing recombinant human al-antitrypsin (rhAAT), comprising the steps of providing a PER.C6 cell with a nucleic acid encoding human al-antitrypsin in such a way that said PER.C6 cell harbors said nucleic acid in an expressible form; and 20 culturing said PER.C6 cell under conditions conducive to the production of said recombinant human al -antitrypsin, wherein said PER.C6 cell is modified to co-express a said sialyltransferase is a2,3 sialyltransferase or a2,6-sialyltransferase.

15. RhAAT obtainable by a method according to claim 14. 25